AB0515 CARDIOVASCULAR RISK FACTORS ASSESSMENT AND CONTROL IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: A. Torcato Cartaxo, N. Carreira, L. Duarte, M. Terenas, C. Mota, P. Gaspar
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic lupus erythematosus (SLE) is an independent risk factor for cardiovascular disease (1). Studies reporting how cardiovascular risk factors (CVRF) are assessed in clinical practice are scarce. Objectives To describe the prevalence of CVRF and characterize the assessment and control of dyslipidaemia and high blood pressure (HBP) in SLE patients. Methods Cross-sectional study of all adult SLE patients (SLICC 2012 criteria) followed in a dedicated clinic in 2019. Patients with less than one year of follow-up or less than three in-person visits were excluded. LDL-cholesterol control was defined as desirable (&lt;115mg/dL), ideal (&lt;100mg/dL), and according to the SCORE risk (2) (low, &lt;115mg/dL; moderate, &lt;115mg/dL; high, &lt;100mg/dL; very high, &lt;70mg/dL). Blood pressure (BP) control was defined as desirable (systolic BP [SBP]/ diastolic BP [DBP]&lt;140/90mmHg) and ideal (SBP/DBP&lt;130/80mmHg). Data are shown as number (%) and median (interquartile range [IQR]) for categorical and continuous variables respectively. We used statistical tests as needed. Results Among 82 SLE patients followed in 2019, 65 met the inclusion criteria (89% female; median age, 52 years; median disease duration, 15 years; median follow-up, 8 years). The median SLEDAI-2K was 2 (0 - 4). Most patients were on hydroxychloroquine (88%), 43% were on steroids and 31% on other immunosuppressants. Dyslipidaemia was present in 62% of patients, followed by HBP (51%), obesity (n = 9,14%) and diabetes mellitus (n = 4, 6%). Once-a-year CVRF assessment in the five years prior to the study was low: lipid profile (LP) - 25% among all patients (33% of patients with dyslipidaemia); BP - 9% of all patients (15% of patients with HBP) (Table 1). In the study year, LP was assessed in 69% of all patients and in 85% (34/40) of patients with known dyslipidaemia, with a median LDL-cholesterol of 96 (128 – 74) mg/dL. Thirty-five (35/40, 88%) patients were under statins and the LP control was desirable, ideal and in line with the SCORE risk in 56%, 53% and 56% of patients, respectively. In the study year, BP was assessed in 32% of all patients and in 39% (13/33) of patients with known HBP, of whom 94% were under antihypertensive drugs. Among these patients (n=13), 69% had desirable and 23% ideal BP control. Steroid treatment regimen prevalence as well as disease activity as measured by the SLEDAI-2K was similar between patients who had LP and BP assessed and controlled compared to those who did not (all p &gt;0.05). Table 1. Prevalence of diagnosis, clinical recognition, drug prescription and control of HBP and dyslipidaemia. Total (n = 65) Subgroup by disease HBP, n (%) 33 (51 ) Clinical assessment 2019 21 (32) 13 (39) Annual 6 (9) 5 (15) Under treatment 31 (48) 31 (94) Control * Desirable 17 (81) 9 (69) Ideal 10 (48) 3 (23) SBP / DBP, mmHg 130 (134–120) / 77 (80–70) 134 (141–130) / 80 (87–75) Dyslipidaemia, n (%) 40 (62 ) Clinical assessment 2019 45 (69) 34 (85) Annual 16 (25) 13 (33) Under treatment 35 (54) 35 (88) Control * Desirable 29 (64) 19 (56) Ideal 24 (53) 18 (53) According to SCORE 28 (62) 19 (56) LDL, mg/dL 97 (124–74) 96 (128–74) *Calculated from the clinical assessment number for each group. Conclusion LP was the most frequently evaluated CVRF but only about one third of patients had their BP measured. Despite treatment, dyslipidaemia and BP control are suboptimal. References [1]Esdaile JM, Abrahamowicz M, Grodzicky T, et al. Traditional Framingham risk factors fail to fully account for accelerated atherosclerosis in systemic lupus erythematosus. Arthritis and Rheumatism , 2001: 44 (10), 2331–2337. [2]Catapano AL, Graham I, De Backer G, et al &amp; ESC Scientific Document Group. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. European Heart Journal , 2016:37(39), 2999–3058. Disclosure of Interests None declared